Eichel B S
Laryngoscope. 1985 Mar;95(3):300-4. doi: 10.1288/00005537-198503000-00012.
In 1981, a series of 236 intranasal ethmoidectomy (INE) procedures was reported with a complication rate of 1.8%. Special attention has subsequently been directed to the surgical failures; namely, recurrent nasal polyposis which accounted for approximately 17%. The reason for recurrence in most instances was felt due to failure to do a more thorough posterior ethmoidectomy and enter and clean out the sphenoid sinuses. Subsequently, in all revision cases where a more thorough sphenoidethmoidectomy (RSE) was performed, the overall long-term success rate raised to better than 90%. Attention to skeletonizing the middle turbinate by stripping mucosa and leaving a thin bony shell is an important technical factor. An attempt is made to leave some of this bony skeletonized medial wall of the middle turbinate as it represents the most crucial landmark in doing the surgery via the intranasal route. There still remains approximately 8% to 10% of this patient population with nasal polyposis and sinusitis of such severity that surgery has offered only a temporary measure of relief. In dealing with this group it may be necessary to see these patients postoperatively at four to six-week intervals, carefully suctioning the ethmoid labyrinth and occasionally doing minor office "touch-up" ethmoidectomy-polypectomy procedures to clean off redundant mucosa or early polyposis. This paper is written to offer a compromise to the two schools of intranasal ethmoidectomy surgery as to the necessity of removing the middle turbinate in its entirety.
1981年，有报告称进行了236例鼻内筛窦切除术（INE），并发症发生率为1.8%。随后，人们特别关注手术失败的情况，即复发性鼻息肉，约占17%。多数情况下复发的原因被认为是未能更彻底地进行后筛窦切除术以及进入并清理蝶窦。随后，在所有进行了更彻底的蝶筛窦切除术（RSE）的翻修病例中，总体长期成功率提高到了90%以上。通过剥离黏膜并保留一层薄骨壳来使中鼻甲骨骼化是一个重要的技术因素。试图保留中鼻甲骨骼化内侧壁的一部分，因为它是经鼻内途径进行手术时最重要的标志。仍有大约8%至10%的鼻息肉和鼻窦炎患者病情严重，手术仅能提供暂时的缓解措施。对于这部分患者，术后可能有必要每隔四到六周对其进行检查，仔细抽吸筛窦迷路，偶尔进行小型门诊“修补性”筛窦切除术 - 息肉切除术，以清除多余的黏膜或早期息肉。本文旨在就鼻内筛窦切除术是否有必要完全切除中鼻甲这一问题，在两种手术流派之间找到一个折中的办法。
